Williams Dennis M, Rubin Bruce K
University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina.
The Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia.
Respir Care. 2018 Jun;63(6):641-654. doi: 10.4187/respcare.06051.
Obstructive lung diseases, including asthma and COPD, are characterized by air-flow limitation. Bronchodilator therapy can often decrease symptoms of air-flow obstruction by relaxing airway smooth muscle (bronchodilation), decreasing dyspnea, and improving quality of life. In this review, we discuss the pharmacology of the β agonist and anticholinergic bronchodilators and their use, particularly in asthma and COPD. Expanding knowledge of receptor subtypes and G-protein signaling, agonist and antagonist specificity, and drug delivery have led to the introduction of safer medications with fewer off-target effects, medications with longer duration of action that may improve adherence, and more effective and efficient aerosol delivery devices.
阻塞性肺疾病,包括哮喘和慢性阻塞性肺疾病(COPD),其特征为气流受限。支气管扩张剂治疗通常可通过舒张气道平滑肌(支气管扩张)、减轻呼吸困难和改善生活质量来减轻气流阻塞症状。在本综述中,我们讨论β受体激动剂和抗胆碱能支气管扩张剂的药理学及其应用,尤其是在哮喘和COPD中的应用。对受体亚型和G蛋白信号传导、激动剂和拮抗剂特异性以及药物递送的认识不断扩展,已促使推出了具有更少脱靶效应的更安全药物、作用持续时间更长可能改善依从性的药物以及更有效和高效的气雾剂递送装置。